Pilar Albarado spent five months after September 11, 2001, cleaning pulverized building material from apartment buildings and offices near the site of the World Trade Center. A chronic cough came two years later, and she is also battling asthma, memory loss and acid reflux.

Only now, almost six years after the attacks, is the extent of the medical toll on firefighters, police and others who worked on the cleanup coming to light, along with questions about how much the government knew of the danger.

Albarado, 44, cannot work because of her medical problems. Her acid reflux is so bad she cannot eat most foods.

She is being treated at the recently opened World Trade Center health clinic at Bellevue Hospital, but she said the medicines they give her do little to help.

"Our problems will be with us for life," she said during a protest outside congressional offices in June. "I will never be the same."

SICKENING DUST

Democrats in Congress say Albarado is one of thousands of people endangered when the Bush Administration knowingly played down the risks posed by the dust, which contained asbestos, lead and other contaminants.

Inhalation of dust-laden air has been implicated in at least two deaths -- from lung inflammation and scarring -- and connected to the respiratory illnesses and even cancers of thousands working and living within miles of Ground Zero, according to medical studies.

Mount Sinai Medical Center researchers found 69 percent of the nearly 10,000 first responders they examined had new or worsened lung problems after September 11, while doctors at New York University School of Medicine documented these problems in lower Manhattan residents.

The Bellevue program is currently treating more than 1,300 such patients, and others are on a waiting list.

Researchers are still working to understand the long-term effects of these exposures and how psychological distress from the event might contribute to physical problems.

"We're finding that there are respiratory problems that are persisting well beyond what we anticipated -- considering people were exposed six years ago," said Alison Geyh at the Johns Hopkins Bloomberg School of Public Health in Baltimore. "The question is why."

The World Trade Center Health Registry, which includes more than 71,000 directly exposed New York City residents and workers, will track their physical and mental health for up to 20 years and may provide some answers, Geyh said in a telephone interview.

CLEARING THE AIR

Jerrold Nadler, a New York Democratic who headed a House of Representatives hearing on the issue in June, said the Environmental Protection Agency issued falsely reassuring statements about air safety and asbestos levels.

This led first responders to work with inadequate protective equipment and New Yorkers to return to "homes, schools and workplaces that had not been properly tested."

Congressional Democrats also faulted the EPA for failing to meet its clean-up responsibilities.

Then Environment Secretary Christie Whitman told the congressional hearings she did not regret her comments, nor her role in reopening Manhattan workplaces on September 17.

She added that she acted on the scientific information she had been given at the time. "I will believe the scientists when they tell me what is safe to breathe," Whitman said.

But according to Geyh, who was at Ground Zero collecting environmental hazard data immediately after the attacks, the complicated circumstances did not warrant such early assurances.

An August 2003 report by the EPA's inspector general found that some of these statements were made without scientific evidence, and also implicated the White House in mitigating health warnings.

Earlier this year, a federal judge ruled that Whitman knowingly lied to New York residents about their health risks. The case is now under appeal.

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